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Hospitals in #Thailand and the West compared

23/01/2015

Hospitals in #Thailand and the West Compared

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Thailand has a reputation for having cheap affordable healthcare for foreigners. Sometimes that is true; sometimes it is not. Many bloggers, travel agents, retirement consultants, and tourist authorities refer to the country as “the hub for medical tourism”. It’s true that many foreigners come to the Land of Smiles for that reason, but let’s look at the services that Thailand’s hospitals and clinics offer and compare them to those available in the West.

Thailand has had a low cost or free healthcare system for its own nationals for less than two decades. England has had a ‘free at point of use” concept since 1948. America has no free healthcare provision and is one of the most expensive countries for medical care: indeed it’s beyond the reach of a large proportion of the American population. Services are under strain in all three countries.

In Thailand, although care can be free, waiting times can be very long at local hospitals in the public sector. The availability of medical expertise is not always as good as in private sector hospitals or hospitals abroad. The UK is under-resourced, appointments can be delayed or cancelled, and it’s not always free (prescription charges are relatively high and hospitals usually impose a car parking fee. Thai private hospitals are like 5 star hotels.

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Here are some comparative figures:

Beds per 1000 of the population, an indication of healthcare availability.

Monaco    20

Japan         14

Australia     7

Europe        6

U.K.              4

U.S.A.           3

Thailand      2

Ranking of Gross Domestic Product per capita spent on healthcare.

France          1    (highest)

Singapore    6

U.K.             18

Australia     32

U.S.A           38

Thailand     48

Malaysia     50

Philippines 65

Burma       190   (lowest)

Monaco is a cash rich country. France funds its medical services largely through taxation. Singapore has a mix of private (66% of total) and public sector provision. It spends 3% of its GDP on healthcare and the government controls quality standards and pricing. The country has one of the highest life expectancies in the world and the second lowest infant mortality rate. If they can afford it, many Thais and farangs (foreigners) go to Singapore or abroad for treatment.

Thailand’s universal healthcare structure, often referred to as the 30 Baht scheme (because when introduced the only cost for Thais in public hospitals was 30 baht plus a contribution to medication costs) is now free for almost all Thais. There is a special scheme for government employees and their families which is also free. Middle class Thais tend to use private hospitals and pay their fees either themselves or through insurance companies. Increasingly, many employers (especially those employing farangs) offer medical care as part of their remuneration package. Even so, two-thirds of spending on healthcare is met by the government. HIV, Tuberculosis, and Malaria cases are still of concern and the average life expectancy of Thais is 66 years.

Siriraj is Thailand’s oldest and largest hospital and is where His Majesty the King has been cared for over the last few years. It is a state hospital. There are always crowds of his subjects paying their respects outside the hospital which overlooks the Chao Praya River in Bangkok.

Most Thai doctors speak English although the nursing staff may not be so fluent. It’s not a particularly serious problem for foreigners as the Thai attitude towards being very caring outweighs any inconvenience. A large number of doctors and surgeons have been trained abroad, principally in the States.

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Westerners will, however, be charged more than Thais and, as private hospitals are first and foremost businesses with shareholders, every effort will be made to increase a hospital’s revenue. Unnecessary procedures and over-medication are quite common. Sometimes that can be justified if the doctor wants to check his diagnosis and believes it’s in the patients’ interests to prescribe extra medication. Sometimes it’s for reasons more associated with profits and bonuses.

Cosmetic surgery is a good money spinners for Thai hospitals. Plastic surgery, skin whitening, and dental care is a quarter of the price charged in the States and is of high standard. Thais would not be charged as much as a farang but have always been conscious of their appearance and, as they get richer, are keen to avail themselves of the advanced techniques and procedures offered. Thailand is very hierarchical and how one looks is not so much showing off as being important in establishing where you stand in the social order.

Sex change operations (gender reassignment) do not have the stigma that they have abroad and, again, are of a high standard in a country that has an acceptance of transsexuals. Katoeys, lady boys, are often so glamourous that they are indistinguishable from women who are born female. Although katoeys have male identification cards, they use ka and not krap when speaking in the same way as all Thai girls and women.

ladyboy

 

 

A Thailand Diary includes some entries on observations and experiences for both farangs and Thais in Thai hospitals.

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One Comment
  1. Matt Owens Rees permalink

    Reblogged this on Matt.Owens.Rees; Thailand Writer.

    Like

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